title: Sildenafil citrate and uteroplacental perfusion in fetal growth restriction.
abstract: BACKGROUND
  To determine whether the phosphodiesterase type 5 inhibitor, Sildenafil citrate, affects uteroplacental perfusion.
  
  
  METHODS
  Based on a randomized double-blinded and placebo-controlled trial, forty one pregnant women with documented intrauterine growth retardation at 24-37 weeks of gestation were evaluated for the effect of a single dose of Sildenafil citrate on uteroplacental circulation as determined by Doppler ultrasound study of the umbilical and middle cerebral arteries. Statistical analysis included χ(2)-test to compare proportions, and independent-samples t-test and paired student's t-test to compare continuous variables.
  
  
  RESULTS
  Sildenafil group fetuses demonstrated a significant decrease in systolic/diastolic ratios (0.60 [SD 0.40] [95% Cl 0.37-0.84], P=0.000), and pulsatility index (0.12 [SD 0.15] [95% Cl 0.02-0.22], P=0.019) for the umbilical artery and a significant increase in middle cerebral artery pulsatility index (MCA PI) (0.51 [SD 0.60] [95% Cl 0.16-0.85], P=0.008).
  
  
  CONCLUSIONS
  Doppler velocimetry index values reflect decreased placental bed vascular resistance after Sildenafil. Sildenafil citrate can improve fetoplacental perfusion in pregnancies complicated by intrauterine growth restriction. It could be a potential therapeutic strategy to improve uteroplacental blood flow in pregnancies with fetal growth restriction (FGR).
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran ; Iranian Ministry of Health and Medical Education, Tehran, Iran.
authors.forename: Marzieh Vahid
authors.initials: MV
authors.lastname: Dastjerdi
authors.forename: Sayedehafagh
authors.initials: S
authors.lastname: Hosseini
authors.forename: Leila
authors.initials: L
authors.lastname: Bayani
keywords: Cerebroplacental ratio; Doppler flow velocimetry; fetal growth restriction; pulsatility index; resistance index; systolic/diastolic ratio